Provider Demographics
NPI:1558664839
Name:AMMONS, RITA CECILE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:CECILE
Last Name:AMMONS
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12 CASE ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2222
Mailing Address - Country:US
Mailing Address - Phone:860-859-7043
Mailing Address - Fax:860-886-9545
Practice Address - Street 1:12 CASE ST
Practice Address - Street 2:SUITE 306
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2222
Practice Address - Country:US
Practice Address - Phone:860-859-7043
Practice Address - Fax:860-886-9545
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT005436225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist